Tummy tuck surgery - Abdominoplasty

What Happens during Surgery?

Abdominoplasty is carried out under general anesthetic but can be performed in some instances under sedation and local anesthetics, though this is rare and recommended only for mini tummy tuck procedures.  Your surgeon will have explained at consultation which type of surgery is best for you.  A mini or partial tummy tuck will be offered if you have less excess fat and muscle laxity and if the problem area is located below your navel.

The operation usually entails a lateral incision running from hip bone to hip bone positioned just above the pubic area.  This keeps scarring in a position that can be covered by regular undergarments and swimwear.  If excess fat and skin is minimal, the surgeon may make a far smaller incision and perform a mini tuck.  But, if there is excess fat and skin to remove above the navel, you will have another incision around the navel as well.  In addition, in some instances, you may have an ‘extended abdominoplasty’ which requires incisions running around the flanks of your lower back. 

In the operation, the skin is separated from the abdominal wall to leave the abdominal muscles visible.  The surgeon stretches, tightens and repositions the muscles, thereby reducing the stomach mass.  The skin is stretched and excess skin and fat are removed (the latter, in a method similar to liposuction) before the skin is adjusted into position and sutured in place.  Even if the navel area is operated on, the navel position will remain the same. 

The skin repositioning may remove or reduce the appearance of some stretch marks but this is an extra benefit, not the aim of tummy tuck surgery. 

Alternative procedures

It may be that you only need liposuction to remove abdominal fat.  Similarly, you may be able to undergo endoscopic abdominoplasty; a procedure useful if you have only minimal amounts of fat and muscle slackness.

Post Abdominal Surgery - Recovery / Convalescence

In the mid to long term, your tummy tuck operation will reveal a much firmer, flatter abdomen that appears more toned and in proportion to your frame and weight.  Most people undergoing tummy tucks are heartened by the results and may even have the added benefit of feeling less self conscious as a result of their new body contours. 

If you adhere to a good, healthy diet suited to your lifestyle and activity levels, and avoid weight fluctuations and remain in generally good health, then there is every likelihood that your tummy tuck surgery, although a major operation, will prove worthwhile and give you the desired results for years to come. 

However, you may have to be patient and wait some weeks or even months to see the full results of your surgery as abdominoplasty is a major operation.

What to expect immediately

You will probably require a one- or two-night stay in hospital and you will experience pain after abdominal surgery, swelling and bruising.  Your abdomen will be dressed with gauze and you may have had drains inserted to remove any build up of fluids.  These are generally removed or changed a week after surgery, while stitches are removed in stages over the course of two weeks.   The gauze may be replaced at this stage with a light support bandage. 

Initially, you may find you are unable to stand upright fully for around a week or more, but you will be advised to take frequent, short walks in order to help improve your circulation.  Your post-operative instructions will also advise no bending, lifting or straining until your abdomen is sufficiently healed.  At rest and when sleeping, you will need to prop a pillow under your knees to keep them bent. 

You may experience some numbness in your abdominal area, but do not be alarmed as this will subside though perhaps not for some weeks.  Keep your surgeon informed of your progress.

You will be advised to convalesce for up to three weeks, so plan in advance and prepare by informing friends, family and work colleagues.  You may well need home care post-op, so ensure you have reliable assistance close at hand as you convalesce.

Long-term care

Scars will be prominent at first, and even worsen for anything up to six months before they fade to acceptable levels at around a year.  Again, this is normal with abdominoplasty and you should find the scars are in a suitable position to cover up with regular underwear and swimwear.

With major surgery like abdominoplasty, you should not resume medium or more strenuous levels of exercise for quite some time; at least not before six weeks after your operation.  Mild and normal activity levels are generally possible within two to three weeks.  The rate at which you recover depends on your general health and the type of surgery you underwent.  Always seek advice from your surgeon to clarify your particular situation. If you experience long-term pain, swelling or any abnormal symptoms or side effects, you must contact your surgeon.

Safety

Tummy tuck surgery is very common and rarely associated with serious risks and complications.  But, as with all cosmetic surgery, there are risks from the surgery itself.  Abdominoplasty is a major operation so you should be fully informed about post-operative care and the likely symptoms as you convalesce so you are aware of any complications early on.

You may also feel that the outcome is not what you intended.  There are no guarantees in cosmetic surgery, but rest assured that the majority of people find the benefits of tummy tuck surgery are relatively long term and they feel physically and psychologically better having opted for it.  Most complications are temporary and relate to post-operative infections, or are due to ongoing pain and swelling. 

There are some other risks and complications you need to be aware of and discuss at consultation stage. 

All cosmetic surgery carries the risk of:

• Infection
• Allergic reaction to anesthetics or analgesics
• Lack of wound healing (excessive bleeding – hematoma)
• Blood clot (possibly deep vein thrombosis, or cardiac or pulmonary risk)
• Fluid accumulation
• Ongoing, excessive pain
• The need for further, possibly corrective, surgery
• Uneven healing of the scar tissue or raised scar tissue (keloids)

What are the risks in Abdominoplasty?

Scarring 

Scars will be bright pink for some time, and take up to a year to fade to acceptable levels.  If you notice they heal over the longer term in ridges (keloids), consult your surgeon as you may need minor corrective surgery.  If you find that leakage occurs from the scars, again, consult your surgeon as you may need antibiotics.

Uneven stomach

It is possible, though rare, that the fat and skin removal has left an uneven look to your abdomen.  The surgeon will have ensured even tightening, repositioning and contouring.  The unevenness may be caused by some fat cells dying (fat necrosis – see below) as a result of the surgical intervention. 

Fat necrosis

This occurs at trauma spots caused during surgery.  When the abdominal wall is stretched, the blood supply to the remaining fat and skin may get damaged.  While rare, this can lead to the death of fat cells, which causes raised hard lumps.  Occasionally, an internal infection can result in these areas.

Skin necrosis

This occurs when the skin is stretched and the underlying blood supply is damaged.  This is more likely to occur if the patient is a smoker or has diabetes.  It can be corrected with skin grafts. 

Cardiac & pulmonary complications and blood clots

With abdominoplasty a major operation, these factors should be considered seriously as potential complications.  While they are possible risks with all surgery, it is wise to speak carefully to your surgeon about your particular likelihood of developing these complications. 

Incorrect position of navel

This is rare, as surgeons are highly skilled in ensuring the correct positioning and contouring of skin.